Ferdy Otten

The socio-economic distribution of heart diseases: Changing gradients in the Netherlands

Two different Dutch data-sets were used to examine trends in the association between socio-economic characteristics and the risk of heart disease. Data of the Dutch Quality of Life Surveys allowed the examination of trends in the association between educational level and self-reported heart disease during the period 1974-1993. For both the general Dutch population and the subpopulation of men aged 40 years and older, we found an inverse gradient during the whole period. The gradient climaxed at 1980-1983, and narrowed afterwards. Furthermore, ecological analyses, relating regional mean personal incomes to regional directly standardised mortality rates of coronary heart diseases (CHD) and all heart diseases, showed similar patterns of social differentials. The findings suggest that, in the Netherlands, there is a narrowing gradient of the association between socio-economic characteristics and heart disease in the late eighties and early nineties.

Impact of the post-2008 economic crisis on harmful drinking in the Dutch working-age population.

BACKGROUND Studies on the impact of economic crises on alcohol consumption have yielded ambiguous results. Therefore, we studied changes in trends in harmful drinking among Dutch working-age men and women after the post-2008 economic crisis started. We also assessed whether these trend changes differed across age and socioeconomic groups. METHODS We used repeated cross-sectional data from the Dutch Health Interview Survey conducted by Statistics Netherlands. Representative samples were independently drawn each month (January, 2004-December, 2013). Our working-age study population consisted of 20,140 men and 22,394 women aged 25-64. For men and women, episodic drinking was defined as drinking ≥6 glasses on one day at least once a week. Chronic drinking was defined as consuming ≥14 glasses/week for women and ≥21 for men. Segmented logistic regression was used to model trend changes separately in men and women. RESULTS A downward trend in episodic and chronic drinking before the crisis slowed down after the crisis started. For episodic drinking, we observed a ceasing-of-decline among men aged 35-44/45-54/55-64, compared to a start-of-decline among those aged 25-34 (p-interaction=0.042/0.020/0.047). For chronic drinking, we observed a ceasing-of-decline among women (p=0.023) but not among men in general (p=0.238). Among men, a ceasing-of-decline did occur in those with a high income, but a start-of-decline was found among those with a low income (p-interaction=0.049). CONCLUSION In some subgroups of the Dutch working-age population, the downward trend in episodic and chronic drinking ceased after the crisis started. This suggests that the crisis had an upward effect on harmful drinking, but only in specific populations.